We report a case of a 14-month-old boy with miliary tuberculosis and recurrent pneumothorax due to cavitations of the left lung. He was admitted to hospital for a severe pneumonia and had to be ventilated with high pressure ventilation for about 4 weeks. He developed left pneumothorax for which several underwater chest drainages were performed. Finally, because of massive enlargement of the lung cavity, a thoracotomy was performed which revealed a 5x5 cm abscsessabscess cavity in the lung. Resection of the affected segment was done. In the postoperative period the child needed repeat chest intubation and prolonged steroid therapy but improved gradually. Histopathology confirmed the diagnosis of pulmonary tuberculosis